Medical association backs health system reform

The American Medical Association on Monday rebuffed dissident members and voted to stick with support for ongoing health reform efforts, while reiterating wariness over proposals that threaten doctors' pocketbooks and independence.

The action at the group's semiannual meeting in Houston could be seen as a vote of confidence for AMA leaders who voiced support for the $1.2-trillion, 10-year bill the U.S. House passed Saturday.

Several dissident doctor organizations within the AMA had urged the group to reverse its position and come out with a strong statement opposing Democrat-led reform efforts. Some urged the AMA's 544-member House of Delegates to vote to oppose any health overhaul that includes a public insurance option and Medicare payment cuts to doctors, and that excludes tort reform.

Discussions about the proposed resolutions spurred a lengthy debate Sunday that went on for more than eight hours.

However, during a two-hour discussion Monday, delegates _ physician members who set AMA policy _ voted instead to follow the more moderate path chosen by AMA's leaders including its president, Dr. James Rohack. Delegates adopted a health reform statement similar to one approved at their annual meeting in June, after President Barack Obama came to Chicago to seek AMA approval for his health reform agenda.

"The message is that the House of Delegates met, and in a very democratic process, voted to support the AMA continuing to work with Congress for a reform of the health care system to make it better for patients and the physicians who take care of them," said the AMA's President-elect Cecil Wilson.

The measures adopted Monday say AMA will support health overhaul that is consistent with AMA policies, including freedom to choose health insurance and universal access for patients. Any health insurance options should not require physicians to participate, or restrict patients' access to out-of-network doctors, the measure says.

The measures also say reform must include a Medicare physician payment system that keeps pace with the costs of running a medical practice. One resolution spelled out the group's opposition to cuts in Medicare payments.

One of the most spirited debates Monday came while discussing a proposed resolution calling for the AMA to actively oppose "any new public health insurance option, which is defined as a federal government backed and/or funded insurance plan."

"My strong concern is that a public option as defined in the resolve would become the only option for patients," said Michael Greene, a representative of the Georgia delegation who introduced the resolution.

Lori Heim, president of the American Academy of Family Physicians, was one of several speakers opposing the resolution. "Despite dire predictions of what may occur, we don't know that. There may be a public insurance option that provides the criteria we are looking for," Heim said. "It's important to keep our options open, to keep the discussion going."

The resolution was voted down by a 315-199 margin, and the AMA's position _ neither opposing nor supporting any specific public option _ stayed unchanged.

Another resolution stating that the AMA should oppose the just-passed House bill also was soundly defeated by a 350-167 vote, again showing delegate support for a previously-stated AMA stand. Last week, the organization expressed support for the bill, but did not give a full endorsement saying the bill was not a perfect fit.

"I would much have preferred to come out strongly against a public option, but I think we also made positive changes," Greene said following the vote.